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Home >> Multiple Sclerosis >> Diagnosing MS

Diagnosing MS

Before initiating treatment for MS, it is important that the diagnosis is correct. This excludes the possibility of other conditions being responsible for any symptoms present.

The importance of a thorough medical review

At present, there is no definitive test to determine if someone has Multiple Sclerosis. The difficulty of diagnosing MS is compounded by the wide variety of symptoms that can appear from one person to the next. MS symptoms can appear similar to those early symptoms may just as easily beof other diseases. Since   caused by several other diseases, it often requires all the experience of a neurologist to diagnose MS. It takes the expertise of a neurologist to: conduct a thorough review of a person's medical history; to request specialised tests; conduct a neurological examination and assess the findings to reach a conclusion.

A diagnosis of MS can only be made after all other possible causes and symptoms have been ruled out.

How is MS confirmed?

Often the first sign of the illness is no more than a passing odd feeling in the arms or legs, which neither the individual nor doctor might regard as being particularly significant. Consequently, several months, or even years, may pass before MS can be diagnosed with confidence.

Diagnosis is based on clinical and para-clinical criteria.

  • Clinical criteria are supplied by the history of the illness, or anamnesis, and the results of the clinical-neurological investigation, namely the clinical findings.
  • Para-clinical criteria are the results of various technical investigations, such as magnetic resonance tomography evoked potentials, and by examining the cerebral fluid.

An accurate diagnosis of MS relies on both clinical and para-clinical parameters.

Further investigations, in addition to these standard procedures may be called for in an attempt to either diagnose MS or exclude MS as the root cause of symptoms.

Receiving a diagnosis of MS can be very distressing, provoking a strong emotional response, and this is perfectly normal. Feelings of shock, fear and grief are common reactions. It is advisable to talk with a specialist MS nurse or doctor, to ask for support on dealing with a confirmed diagnosis of MS diagnosis and to seek guidance on how best to treat the disease. It is also advisable to gather information and experience through MS patient associations and forums

What is a relapse?

The diagnostic hallmark of MS is the relapse or exacerbation, which is defined as; the unprovoked and unanticipated occurrence of a new symptom, or recurrence of an old symptom, lasting for a period of greater than 24 hours.

The time and course of a relapse or exacerbation is one of the few relatively consistent and predictable aspects of the disease. Typically, a relapse will develop over a matter of days, remain constant for three to four weeks, and then slowly resolve over a period of about a month.

What happens in a neurological examination?

When carrying out a neurological investigation, the functional condition and efficacy of the nervous system are examined and tested.

Examining the cerebral nerves

In examining the cerebral nerves it is essential that facial movement and visual efficiency (eye movement) are tested. A special lamp known as an ophthalmoscope can be used for painless observation of the fundus, at the point where the visual nerves enter the eye.

Testing reflexes

Reflexes are tested with a small rubber hammer. A reflex is an involuntary reaction of the nervous system to an external stimulus. The knee-jerk reflex, for example, is a reaction of the relaxed musculature to a tap just below the kneecap. Weak, absent or excessive reflexes and different reflex behaviour in each side of the body are significant factors in an MS-diagnosis. Abdominal skin reflexes are responses to stroking the skin of the abdomen. A doctor will look for an abnormal response, sometimes referred to as Babinski's reflex, by firmly stroking the outer edge of the foot.

Testing muscular strength

Muscular strength and muscle interplay are scrutinised when investigating motor behaviour. Sensitivity is tested by assessing the perception of touch, pain, temperature, vibration and location. The vegetative nervous system regulates automatic life-functions such as breathing or digestion. Doctors can investigate the vegetative nervous system by thoroughly examining bladder, intestinal functions, breathing and circulation.

It is also common clinical practice in diagnosing MS, for a psychological assessment of awareness, orientation, concentration, attention and overall mood, to be carried out.


For more information on how MS is diagnosed, contact your local healthcare provider. You can also visit http://www.ms-network.com/


This quick guide is supported by Merck Serono.